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    <h1>龙门县人民医院</h1>
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            <label for="name">姓名:</label> <input id="name" class="input" type="text" name="name"
                                                  placeholder="请输入您的姓名"/>
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            <label for="checkid">检查号:</label> <input id="checkid"  class="input" type="text"
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                                                     placeholder="请输入您的检查号码"/>
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<footer class="page-footer">
    <p class="info-row"><span class="key">地址:</span> <span class="value">广东省惠州市龙门县龙城镇西林路一号</span></p>
    <p class="info-row"><span class="key">电话:</span> <span class="value">0752-7895801</span></p>

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            Copyright © 2013-2018 <strong>龙门县人民医院</strong>&nbsp;All Rights Reserved.
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